Incident investigation·December 16, 2024

On 12/16/24 around 08:00 AM, L. Holmes Licensing Program Analyst (LPA) arrived unannounced to conduct a case management for an incident of alleged client abuse that was self-reported by the facility. The report was received by Community Care Licensing Department (CCLD) on 12/06/2024, dated 12/04/24. LPA met with Lenie Ibe, Staff and explained the purpose of the visit. During the visit LPA interviewed Staff (S1, S2), Resident #1 (R1), and obtained a Resident Roster, Staff Roster, and requested the following for Resident #1 (R1): current Physician's Report, Appraisal and ID/Emergency Contact information. LPA requested the following for Staff #1 (S1): Training Records, disciplinary action, and photo identification. S1 resigned on 12/05/24. S1 was not at the facility during the time of the visit; however, S1's name remains on the Staff Roster and removal was requested. LPA confirmed with CCLD's Staff Support, A. Christy, that S1 is associated to multiple CCLD Adult and Senior Care facilities. Once all the information has been reviewed, CCLD will determine whether an immediate exclusion or non-immediate exclusion will be initiated. -Around 10:10 AM, LPA reviewed S1's personnel records. S1's most recent training records were dated 05/08/22. S1 did not have any current training records on file. Deficiency cited from Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction by plan of correction due date, and any repeat violations within a 12-month period may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights were provided to Lenie Ibe, Staff.